{"id":6485,"date":"2024-06-11T08:18:37","date_gmt":"2024-06-11T08:18:37","guid":{"rendered":"https:\/\/hcp.biomarin.com\/en-us\/pku\/?page_id=6485"},"modified":"2024-06-24T11:56:40","modified_gmt":"2024-06-24T11:56:40","slug":"connect-with-us","status":"publish","type":"page","link":"https:\/\/hcp.biomarin.com\/en-us\/pku\/connect-with-us\/","title":{"rendered":"Stay connected with the latest PKU information"},"content":{"rendered":"<div id=\"acf-block-666809ab35c73\" class=\"block hcp-sign-up-form\">\n    <div class=\"wrapper\">\n        <div class=\"inner-wrapper\">\n                            <h2>Stay connected with the latest PKU information\n<\/h2>\n                        <div class=\"block form-box\">\n                                    <p>Register below to connect with a BioMarin representative, learn about upcoming PKU events and news, or request a peer-to-peer discussion.<\/p>\n<p>* Required fields<\/p>\n                \n                <form id=\"hcp-sign-up\" name=\"Stay connected with the latest PKU information\">\n                    <div class=\"form-item\">\n                        <label for=\"first-name\">First name<span class=\"required\">*<\/span><\/label>\n                        <input class=\"text\" id=\"first-name\" type=\"text\" required\n                        data-pristine-required-message=\"Please enter your first name.\">\n                    <\/div>\n\n                    <div class=\"form-item\">\n                        <label for=\"last-name\">Last name<span class=\"required\">*<\/span><\/label>\n                        <input class=\"text\" id=\"last-name\" type=\"text\" required\n                        data-pristine-required-message=\"Please enter your last name.\">\n                    <\/div>\n\n                    <div class=\"form-item\">\n                        <label for=\"email\">Email address<span class=\"required\">*<\/span><\/label>\n                        <input class=\"text\" id=\"email\" type=\"email\" required\n                        data-pristine-required-message=\"Please enter your email address.\">\n                    <\/div>\n\n                    <div class=\"form-item\">\n                        <label for=\"phone-number\">Phone number<\/label>\n                        <input class=\"text\" id=\"phone-number\" type=\"text\"\n                        data-pristine-required-message=\"Please enter your phone number.\"\n                        data-pristine-pattern-message=\"Please enter a valid phone number.\"\n                        data-pristine-pattern=\"\/^\\(?([0-9]{3})\\)?[-. ]?([0-9]{3})[-. ]?([0-9]{4})$\/\">\n                    <\/div>\n\n                    <div class=\"form-item\">\n                        <label for=\"zip-code\">Postal Code<span class=\"required\">*<\/span><\/label>\n                        <input class=\"text\" id=\"zip-code\" type=\"text\" required\n                        data-pristine-required-message=\"Please enter your ZIP code.\"\n                        data-pristine-pattern-message=\"Please enter a valid ZIP code.\"\n                        data-pristine-pattern=\"\/^\\d{5}(-\\d{4})?$\/i\">\n                    <\/div>\n\n                    <div class=\"form-item\">\n                        <label for=\"medical-speciality\">What best describes you?<span class=\"required\">*<\/span><\/label>\n                        <select class=\"text\" id=\"medical-speciality\" required\n                        data-pristine-required-message=\"Please select your medical specialty.\">\n                            <option value=\"\">Please select<\/option>\n                            <option>Anesthesiology<\/option>\n                            <option>Audiology<\/option>\n                            <option>Behavioral Neurology &#038; Neuropsychiatry<\/option>\n                            <option>Biology<\/option>\n                            <option>Biomedical Engineering<\/option>\n                            <option>Cardiology<\/option>\n                            <option>Clinical Biochemical Genetics<\/option>\n                            <option>Dentistry and Odontology<\/option>\n                            <option>Dermatology<\/option>\n                            <option>Diagnostic Radiology<\/option>\n                            <option>Electroencephalography<\/option>\n                            <option>Endocrinology, Diabetes &#038; Metabolism<\/option>\n                            <option>ENT\/Otorhinolaryngologist<\/option>\n                            <option>Epileptology<\/option>\n                            <option>Gastroenterology<\/option>\n                            <option>General Practice\/Family<\/option>\n                            <option>Genetics<\/option>\n                            <option>Hemostaseology<\/option>\n                            <option>Hearing and Speech<\/option>\n                            <option>Hematology<\/option>\n                            <option>Hematology &#038; Oncology<\/option>\n                            <option>Hemophilia Treatment Center Director<\/option>\n                            <option>Hepatology<\/option>\n                            <option>Infectious Diseases<\/option>\n                            <option>Infusion Nurse<\/option>\n                            <option>Infusion Therapy<\/option>\n                            <option>Intensive Care<\/option>\n                            <option>Internal Medicine<\/option>\n                            <option>Kinesiology<\/option>\n                            <option>Laboratory Management<\/option>\n                            <option>Medical Student<\/option>\n                            <option>Neonatology<\/option>\n                            <option>Nephrology<\/option>\n                            <option>Neurology<\/option>\n                            <option>Neuromuscular Medicine<\/option>\n                            <option>Nurse<\/option>\n                            <option>Nurse Practitioner<\/option>\n                            <option>Nutrition, Metabolic<\/option>\n                            <option>Obstetrics<\/option>\n                            <option>Occupational Health<\/option>\n                            <option>Oncology<\/option>\n                            <option>Ophthalmology<\/option>\n                            <option>Orthopedics<\/option>\n                            <option>Palliative\/Hospice<\/option>\n                            <option>Pediatric Allergy\/Immunology<\/option>\n                            <option>Pediatric Anesthesiology<\/option>\n                            <option>Pediatric Cardiology<\/option>\n                            <option>Pediatric Dentistry<\/option>\n                            <option>Pediatric Endocrinology<\/option>\n                            <option>Pediatric Endocrinology, Diabetes &#038; Metabolism<\/option>\n                            <option>Pediatric ENT<\/option>\n                            <option>Pediatric Gastroenterology<\/option>\n                            <option>Pediatric Gastroenterology &#038; Metabolism<\/option>\n                            <option>Pediatric Genetics<\/option>\n                            <option>Pediatric Hematology<\/option>\n                            <option>Pediatric Hematology-Oncology<\/option>\n                            <option>Pediatric Metabolism<\/option>\n                            <option>Pediatric Neurology<\/option>\n                            <option>Pediatric Neurosurgery<\/option>\n                            <option>Pediatric Oncology<\/option>\n                            <option>Pediatric Ophthalmology and Strabismus Specialist<\/option>\n                            <option>Pediatric Orthopedics<\/option>\n                            <option>Pediatric Pneumology<\/option>\n                            <option>Pediatric Radiology<\/option>\n                            <option>Pediatric Rheumatology<\/option>\n                            <option>Pediatrics<\/option>\n                            <option>Pharmacist<\/option>\n                            <option>Phonoaudiology<\/option>\n                            <option>Physiatry<\/option>\n                            <option>Physician Assistant<\/option>\n                            <option>Physiotherapy<\/option>\n                            <option>Primary Care<\/option>\n                            <option>Psychology \/ Psychiatry<\/option>\n                            <option>Pulmonology<\/option>\n                            <option>Radiology (MRI imaging)<\/option>\n                            <option>Research<\/option>\n                            <option>Rheumatology<\/option>\n                            <option>Social Worker<\/option>\n                            <option>Surgery<\/option>\n                            <option>Transfusion Medicine<\/option>\n                            <option>Traumatology<\/option>\n                            <option value=\"Unknown\">Other<\/option>\n                        <\/select>\n                    <\/div>\n\n                    <div class=\"form-item check-item\">\n                        <input type=\"checkbox\" id=\"rep-contact-me\" name=\"rep_contact_me\">\n                        <label for=\"rep-contact-me\">I\u2019d like a BioMarin representative to contact me to learn more about PKU resources.<br><small><em>A representative will reach out to you shortly.<\/em><\/small><\/label>\n                    <\/div>\n\n                    <div class=\"form-item check-item\">\n                        <input type=\"checkbox\" id=\"accept-ts-cs\" name=\"accept_ts_cs\" required\n                        data-pristine-required-message=\"Please agree to the terms of use.\">\n                        <label for=\"accept-ts-cs\">By checking the box to the left and clicking &ldquo;Submit&rdquo; below, I confirm I am at least 18 years old; and confirm I agree to BioMarin\u2019s <a href=\"https:\/\/www.biomarin.com\/data-privacy-center\/\" target=\"_blank\">Privacy Policy and CCPA Notice<\/a> and <a href=\"https:\/\/medinfoterms.com\/\" target=\"_blank\">Terms of Use<\/a>; consent to BioMarin, its successors, agents, and\/or assigns using the email address I have provided to keep me informed about updates about news and developments about PKU; and confirm I understand these communications\/materials may contain information that markets or advertises BioMarin products, goods, or services.<span class=\"required\">*<\/span><\/label>\n                    <\/div>\n\n                    <div class=\"form-item\">\n                        <input type=\"submit\" class=\"button\" value=\"Submit\">\n                    <\/div>\n                <\/form>\n                <form id=\"mktoForm_3470\" style=\"display:none;\"><\/form>\n            <\/div>\n\n            <div class=\"block form-success-confirmation\" style=\"display:none;\">\n                                    <h3>Thank you!<\/h3>\n<p>We&#8217;ll be in touch soon with additional information.<\/p>\n                                            <\/div>\n        <\/div>\n    <\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-6485","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Stay connected with the latest PKU information - BioMarin PKU DSE HCP EN-US<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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